HomeMy WebLinkAbout06090049 Application
City of Cannell Clay Township' Permit #: 0 Cerilo rlfJ
RESIDENTIAL IMPROVEMENT LOCATION PERMIT APPLICATION
For Single Family, Multi-Family, &. Two Family: New Structures, Additions, Remodels, &. Accessory Structures
BUILDER of
RECORD:
NAME ,/VI + .
," l(.tr ''1.
STREET ADDRESS . L. r
I .,;l ~ I 6....."''' l mvtJ
, PHONE
) gy - "13 l/ '1
FAX
CfJ...fa- YY31
CIlY
4v_e.
STATE
X::v'
ZIP
BUILDER'S EMAIL ADDRESS
de;. visl'1 ,,) Ie;, ",.,
BEST METHOD OF CONTACT:
L'E../I 01 ~- 5'(,.). I
PROPERTY
OWNER:
NAME
'7~
PHONE
FAX
"" s "'-("CI v e-
STREET ADORESS
CITY
STATE
ZIP
LOCATION
&. PROJECT
INFO:
LOT #
7
SUBDIVISION NAME
l:::~el'aftfJ
SECTION
ZONING:
SEWER LfTlLITY
PROVIDER: Co. ~ HAe- I
Ch: sf
2? 1\10\
SQUARE
FOOTAGE:
1000
#
WATER UTILITY I
PROVIDER: Ca...-J /II,' .
ESTIMATED COST OF CONSTRUCTION: If
(EXCLUDING LAND VALUE) / () 000
NAME OF UTILITY EXCAVATION CONTRACTOR; PLAN COMMISSION I BZA I BPW DOCKET
NUMBERS; TAC DATE(S); AND/OR COUNTY WELL AND/OR SEPTIC PERMIT "S (IF APPLICABLE):
TYPE OF CONSTRUCTION: TYPE OF IMPROVEMENT: PLUMBING CONTRACTOR:
o SINGLE FAMILY ~;:r 0 NEWSTRUCT,YR..E.;(~::::,\ 7<.ke- /III,/k,. Nvwrbl'H?
o TOWN HOME \ ' ' d' . #
o TWO FAMILY Y\ 0, ROOM_,A9Pf!W~(?t\\~\\\Plumber's In ,ana State license :
# of units: -:G~ g,,....eQ.RCitgflD.p.IJJON(S\, 'j\ Pel q 700 "'J '-I d...
O ,.00-", REMODEl<- \' \\
MULTI-FAMILY .; ,-;:'~CiJ:o;;,ACEESSORY BU~NG '~WhiCh plumbing codes will be applied to the construction:
# of Units: ' ",~ I \
rsi RESIDENTIAL (For '\\\~~DETACHEg ~ O~ntemational Residential Code wI Indiana Amendments
Additions, Remodels, Etc,) \\" ~ A~E RAGE 0 Uniform Plumbing Code wI Indiana Amendments
\\\~\DE TION ~Multi-Famlly Construction Code)
PROJECT INFORMATION: \ ~ ~
M \'f~ct d ~~-, FOUND~TION TYPE:, (Check all that apply for the new
Early Release / an" d ure ~ _, /____ ---constructIon area).. ,
Permit: _Y ~N Trusses:~_Y ~NI-"; (r-C!?'- II \Iii ,:-.- ,"
Lot Split: _Y /N Sump ~jjmp: /y ~,i \~10,=..-c:o ~::::LSPAC~iI \\'1: ~~~M&E~~M
liUJ -d/.' \
lie within a special Flood\designatio : 01N! II WALKOUT: y--LN
If \1, ." , I
For Single Fam6kJ@~J..,"J:_' ,:wplligg~.ho<Jsl(I.i.~tOnsr,~t;:1!!. e s. kh1dJdr!acc sory structures, this peir'rriii is1valid only if construction commences
within 180 days of lh: cJo . ~'~~Ji!.rM:~~IJh'~~LJMihgPH'fi\1t9~;Mu..k~bC comp'let~(Cenincate.of.O~plncy issued) within I8 months of the
issuance date. CJa~L'itruAwr ,~rft\'t%ti-S~Bjc~li'Ga& General AHministrative Rules of the State of IndianJ (See 675 lAC 12) regarding expiration
Ut:t-' IUF QMMUN/flilpt ~~~ingand completing~!:O'E~_~
I, the undersige~(e)fao~ctj~fe.ho.os ' r t'.men.t~telocation, or alteration of a structure, or any change in the use of land or
structures requested by TIns app1ica't'iO'n'"1.-h1I c~yWi , w" all applicable Jaws of the State of Indiana, and the ~Zoning Ordinance of Carmel
Indiana - 199r (Z~ 289) and amt'ndmd~under authority of LC. 36~7 ct seq, General Assembly of the State of Indiana, and all Acts amendatory
thereto, I further certify that only kitchen, bath:-and Ooor drains are connected to the sanitary sewer. I further certify that the construction will not be
used or occu i unt' a Ce "care of Occupancy has been issued by th~Aartment of Community Services, Carmel, Indiana.
, /1/c.Y'+.,., \)A /fJ~ C:;. ~-Ob
Signature of Owner or Authorized Agent Date
INSPECTIONS REQUIR
Upper Footing Lower Footing
0U9h 0) Meter Base
*********************************************
/32.,5 0
III,()O
-5"3 . .5 0
# Charged Re-
Reviews
P,R.LF,:
Additional Fees
?L-\
Reviewed/Appr ved: Dept. of Community Services
S:Permits/F~mS/ILP RESIDErmAL
'1-I'r ~
(Date)
~~()O
Fee Received by: